Evaluation of probiotics' efficiency on cariogenic bacteria: randomized controlled clinical study.

BACKGROUND: Probiotics are live beneficial bacteria to human health and their efficiency on oral health is still being investigated. The purpose of this study was to evaluate the level of Streptococcus mutans and Lactobacillus species with and without the use of probiotics for six-months after the treatment of all dental caries under general anesthesia. METHODS: Fifty-eight pediatric patients without any systemic diseases, whose dental treatments were completed under general anesthesia (GA), were included in the study. The patients were recruited in two-groups; Group A: Patients started using probiotics after GA and Group B: Patients did not use probiotics after GA. Saliva samples were taken from all patients on the day before GA (T0), at one-month (T1), three-month (T2) and six-month (T3) follow-up after GA. The counts of cariogenic bacteria were determined by the analysis of saliva samples using real-time polymerase chain reaction. Statistical significance level was accepted as p < 0.05. RESULTS: There was statistically significant difference between Group A and B for T0, T1, T2 and T3 regarding S. mutans (p = 0.001, p = 0.04, p = 0.04, p = 0.03; p < 0.05). However, there was no statistically significant difference between groups regarding Lactobacillus species (p ≥ 0.05). CONCLUSIONS: Probiotic use and treatment of all caries significantly reduced the level of S. mutans but not Lactobacillus species. Furthermore, S. mutans decreased after cessation of probiotics, but it was not statistically significant. TRIAL REGISTRATION: Study was registered as "Effects of Probiotics on Streptococcus mutans and Lactobacillus species" with the registration number of NCT05859646 (16/05/2023) at https://www. CLINICALTRIALS: gov Protocol Registration and Results System.

Attitudes and emotional status of parents regarding traumatic dental injuries.

BACKGROUND/AIMS: Traumatic dental injuries have different effects on children and their parents, depending on the type of trauma and whether it is in primary or permanent teeth. Parents do not always seek immediate intervention for their children after each traumatic dental injury unless accompanied by conditions such as pain or bleeding that will increase emotional stress. The aim of this study was to evaluate the emotional status of parents and parents' attitudes toward urgent intervention for different traumatic dental injuries in both primary and permanent teeth. MATERIAL AND METHODS: A questionnaire consisting of two parts was designed with a reliability coefficient of 0.87 according to the results of a pilot study. The questionnaire was sent to parents as a Google Form via online communication methods such as WhatsApp and e-mail. The first part included questions about the demographic data of the parents and children, and the second part consisted of images of traumatic dental injuries of primary and permanent teeth with questions to evaluate the emotional state of the parents and awareness of the necessity for urgent intervention. The Visual Analog Scale (VAS) was used to evaluate the emotional state, and "Absolutely yes;" "Yes;" "I don't have an idea;" "No;" and "Absolutely no" statements were used to evaluate parents' attitudes about urgent intervention. Categorical variables were shown as numbers and percentages and analyzed with Pearson chi-square. Statistical significance was evaluated for p < .05, and correlations between variables were calculated with Pearson correlation. RESULTS: The survey was completed by 845 parents. All traumatic injuries except extrusion (p = .202; p ≥ .05) had statistically different VAS scores for primary and permanent teeth (p < .05). Parents' attitudes for urgent intervention were statistically significant for all traumatic injuries (p < .05) except 4-mm intrusion (p = .062; p ≥ .05), alveolar fracture (p = .282; p ≥ .05), complicated crown fracture (p = .136; p ≥ .05), and non-traumatized healthy teeth (p = .110; p ≥ .05). CONCLUSIONS: Traumatic dental injuries with excessive bleeding or tissue loss affect the emotional status of parents more than simple injuries, and they prefer to refer to dentists immediately. Parents responded with higher VAS scores and stronger desires for urgent intervention for permanent teeth injuries compared with primary teeth injuries which shows that parents still do not care about primary teeth as much as permanent teeth.

Do hypomineralized teeth affect parents' emotional states and attitudes more than other discoloration conditions?

Discoloration poses a significant esthetic issue, and parents' opinions and emotional states may vary regarding different types of discoloration, such as molar incisor hypomineralization, caries or chromogenic bacteria. This study aimed to assess parent's emotional state and attitudes towards discoloration in primary and permanent teeth. A two-part questionnaire was designed, consisting of questions about demographic data and simulated visuals of different primary and permanent teeth discoloration conditions. The Visual Analog Scale (VAS) was used to determine the emotional state, while parents' attitudes towards dental consultation for each simulated visual were determined using statements such as "Absolutely yes"; "Yes"; "I don't have an idea"; "No"; "Absolutely no". The simulated visuals included cases of "caries with cavitation", "yellow-brown hypomineralized area", "white hypomineralized area" and "chromogenic bacteria". The questionnaire was distributed to 300 parents through online communication channels. Categorical variables were analyzed using Pearson chi-square, with statistical significance set as p < 0.05. A total of 230 parents completed the questionnaire. The highest VAS scores and the highest percentage of "Absolutely yes" responses were observed for "caries with cavitation" in both primary (77.8%, 81.7%) and permanent (60.4%, 94.3%) teeth. Additionally, statistically significant differences were found in the VAS scores for chromogenic bacteria (p = 0.04), caries with cavitation (p = 0.005), white hypomineralized area (p = 0.01) and yellow-brown hypomineralized area (p = 0.02). Comparatively, parental preferences showed statistically significant differences for chromogenic bacteria (p = 0.01), caries with cavitation (p = 0.01), yellow-brown hypomineralized area (p = 0.01) and white hypomineralized area (p = 0.004). Parents displayed stronger emotional responses towards "caries with cavitation" compared to hypomineralization and chromogenic bacteria discolorations and expressed a positive attitude towards seeking dental consultation.

Evaluation of gap formation for different adhesive agents in primary teeth with optical coherence tomography.

Purpose: This study aimed to evaluate gap formation between the tooth surface and restorative material in terms of microleakage by using optical coherence tomography (OCT) for self-etch and selective-etch applications of two different universal and one self-etch adhesives. Materials and methods: Sixty non-caries, primary molar teeth were divided into six groups; self-etch and selective-etch application ways of two different universal and one self-etch adhesive systems (n:10). After Class-V cavities were prepared, every tooth was distributed randomly in groups to apply adhesion procedure and then, all cavities were restored with polyacid-modified composite resin. Microleakage was evaluated by measuring the gap between the tooth surface and restoration by a blind researcher with Image J Software from OCT images. During statistical analysis, the significance level was accepted as p<0.05. Results: According to the statistical analysis of the measurements obtained by Image J Software, selective-etch groups showed less gap formation than self-etch groups for each tested adhesive (p<0.05), and self-etch adhesive without etching showed significantly highest gap formation among all groups (p<0.05). Conclusion: Universal adhesives with a selective-etching step might be preferred over self-etch adhesives for long-lasting polyacid-modified composite resin restorations in primary teeth. However, obtained results should be considered with another prospective clinical study for long-term prognosis.